Medicare Myths Busted: What Every Missouri Senior Should Know in 2025
Medicare is powerful—but confusing. And myths spread fast. If you live in Washington, MO or the surrounding area, getting the facts can save you money and stress. Here are the biggest myths we hear at Wilson & Co. Insurance—and the truths you need in 2025.
Myth #1: “Once I pick a plan, I’m stuck forever.”
The truth: You can switch plans during specific windows each year (and certain life events trigger special windows). If your premiums, doctors, or prescriptions change, you may have better options at your next opportunity.
- Mark your calendar for the Annual Enrollment Period each fall.
- Moving counties, plan changes, or qualifying events can open Special Enrollment.
- Bring your current plan and meds list to a local review at Wilson & Co.
Myth #2: “Original Medicare covers everything I need.”
The truth: Parts A and B have gaps (deductibles, coinsurance) and don’t include everything (like routine dental or most prescriptions). Many people add a Medigap policy, a Medicare Advantage plan, and/or Part D for medications.
- Consider total out-of-pocket, not just premiums.
- Check that your preferred doctors and pharmacies align with your choice.
- Review annually; formularies and networks change.
Myth #3: “The cheapest monthly premium is always the best value.”
The truth: Low premiums can mean higher costs at the pharmacy or doctor. If you take brand-name medications or have regular specialist visits, a higher-premium plan could cost less overall.
- Compare total cost: premiums + copays + coinsurance + drugs.
- Verify your prescriptions in the plan’s drug list.
- Ask us to model your likely annual spend based on your current care.
Myth #4: “My friend’s plan will work perfectly for me.”
The truth: Great for them—maybe not for you. Health needs, doctors, and medications vary. Your best plan is the one that fits your situation.
- Make a personal list: doctors, pharmacies, prescriptions, budget.
- Bring it to a local comparison session at Wilson & Co.
Myth #5: “I don’t need help—Medicare is straightforward.”
The truth: It’s complicated, and it changes every year. A short meeting can prevent costly mistakes and give you confidence you’re covered properly.
How to Get Medicare Right in 2025 (Step-by-Step)
- List your care: doctors, specialists, hospital preferences, and prescriptions.
- Bring last year’s costs: premiums, copays, and notable bills.
- Compare options: Original Medicare + Medigap + Part D vs. Medicare Advantage.
- Check networks & formularies: ensure your doctors and drugs are covered.
- Plan for change: review annually; adjust as needs evolve.
Local Tips for Missouri Seniors
- Confirm your preferred providers around Washington/Franklin County are in network.
- Ask about pharmacy tiers—your usual pharmacy could change your copay amounts.
- If you split time between counties or travel, make sure your plan travels well, too.
Case Snapshot: A Better Fit, Lower Cost
A Wilson & Co. client was paying a low premium, but high pharmacy costs for a brand-name medication. We found a plan with slightly higher monthly premium but dramatically lower drug copays—saving hundreds over the year while keeping their doctors in network.
FAQ (Straight Answers)
Does Original Medicare include drug coverage?
No. You’ll want a Part D plan for prescriptions, or a Medicare Advantage plan that includes drug coverage. We’ll help you compare both approaches.
Can I keep my doctor?
Usually, yes—if your doctor is in-network for the plan you choose. We’ll verify your providers during your review.
Is dental or vision included?
Not in Original Medicare. Some Medicare Advantage plans include dental/vision; Medigap does not. We’ll show you options that add these benefits.
Your Next Move
You don’t need to memorize every rule to make a great decision. You just need a local guide who will put your needs first and review your options clearly.
Ready for a friendly, no-pressure Medicare review? Start at the Wilson & Co. homepage or browse insights on the Wilson & Co. blog. Bring your doctors and medication list—we’ll do the rest.
